Advanced IV Access
Existing Central Lines are very easy to access.
Arizona Paramedics may access these with proper
training and with proper Base Medical Control.
Different types of Existing Central Lines
1. Hickman, Broviac,
2. Groshong
3. Port-A-Cath
4. PICC
Remember that
these are
CENTRAL LINES
and must be
treated with very
ASEPTIC
Technique.
Used for:
Chemotherapy, Blood, TPA, Heparin, Other medications
Advantages:
Medication delivered into large vessel
Medication does not damage vessels
Patient does not need repeated IV access needle sticks
Disadvantages:
Requires surgical insertion
Pneumothorax at time of insertion
Bleeding at site
Hematoma at site
Infection
Site needs continual care and dressings
Port and tubing outside on chest/neck
Thrombosis formation
Potential Problems
Hematoma/Bleeding at site
Apply direct pressure
Infusion slow/sluggish
Check for kinked tubing
Reposition patient
Raise arm on same side as catheter
Roll patient to opposite side
Have patient sit up
Have patient take deep breath or cough
(Be creative) Try whatever comes to mind!!!
Potential Problems
Infiltration/Extravasation
Clamp tubing
Air embolism (respiratory distress)
Clamp catheter immediately and turn patient on left side
with head down so air enters the right atrium and
pulmonary artery. Maintain this position for 20-30
minutes.
PORT-A-CATH
REQUIRES A SPECIAL NEEDLE FOR ACCESSING called a (HUBER
NEEDLE)-Non Coring Needle
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Wash hands thoroughly. Put on gloves
Aseptic technique is to be used
Gather Supplies (Huber needle, syringe, IV Solution)
Open Huber Needle, flush it with NS to purge air.
Locate the portal septum by palpation, cleanse skin with betadine
then alcohol. Inform patient that you will be inserting needle.
Insert needle.
Release the clamp on needle tubing and flush with 1cc NS
Withdraw 8-10cc of blood, clamp tubing, remove syringe and
discard blood.
Unclamp tubing and run IV Solution at desired rate.
Place a sterile 2X2 gauze pad underneath the hub of the needle.
Place transparent dressing over the needle.
Huber Needle
Any Questions
?